Texas requires health care providers to report HIV and AIDS under Texas Administrative Code Title 25, Chapter 97. The DSHS 13-13674 is the confidential case report for non-acute HIV infection or AIDS in a patient aged 13 or older, the Texas version of the CDC adult case report. It captures demographics, diagnosis facility, history, labs, clinical status and treatment.
The provider who diagnoses or treats HIV or AIDS completes it, leaving the health department sections blank; there is no patient or employer part.
Download the current version from the source each time; forms change without notice.
Adult HIV/AIDS Confidential Case Report Form
If your copy of the form is a fillable PDF, upload it once and Vero Documents fills it from the visit note and the chart, ready for you to review and sign. Download, print, or email the finished form, with the patient’s consent.
A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.
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You can't download it from DSHS. The provider reporting page lists the Adult HIV/AIDS Confidential Case Report but tells providers to contact their local reporting authority to get a copy. DSHS posts the list of HIV and STD local reporting authorities by region.
By phone. DSHS lists acute HIV infection as phone-only, due within one working day, with no form. Non-acute HIV and AIDS in patients 13 and older are reported on the 13-13674 within 7 calendar days, and pediatric cases on the 13-13675.